Can preoperative liver MRI with gadoxetic acid help reduce open-close laparotomies for curative intent pancreatic cancer surgery?

Can preoperative liver MRI with gadoxetic acid help reduce open-close laparotomies for curative intent pancreatic cancer surgery?

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Abstract Objectives To evaluate gadoxetic acid-enhanced liver MRI (EOB-MRI) versus contrast-enhanced computed tomography (CECT) for preoperative detection of liver metastasis (LM) and reduction of open-close laparotomies for pancreatic ductal adenocarcinoma (PDAC).Methods Sixty-six patients with PDAC had undergone preoperative EOB-MRI and CECT.LM detection by EOB-MRI and CECT and their impact on surgical planning, open-close laparotomies were compared by clinical and radiology reports and retrospective analysis of imaging by two blinded independent readers.Histopathology or imaging follow-up was the reference standard.

Statistical analysis was performed at patient and lesion Servo levels with two-sided McNemar tests.Results EOB-MRI showed higher sensitivity versus CECT (71.7% [62.1-80.

0] vs.34% [25.0-43.8]; p = 0.

009), comparable specificity (98.6%, [96.9-99.5] vs.

100%, [99.1-100], and higher AUROC (85.1%, [80.4-89.

9] vs.66.9%, [60.9-73.

1]) for LM detection.An incremental 7.6% of patients were excluded from surgery with a potential reduction of up to 13.6% in futile open-close laparotomies due to LM detected on EOB-MRI only.

Conclusions Preoperative EOB-MRI has superior diagnostic performance in detecting LM from PDAC.This better Bangers informs surgical eligibility with potential reduction of futile open-close laparotomies from attempted curative intent pancreatic cancer surgery.